Sifat Jubaira/LinkedIn
Feb 2, 2026, 17:16
Sifat Jubaira: Effect of Prolonged Tourniquet Application
Sifat Jubaira, Lab Medicine Specialist at United Hospital Limited, shared a post on LinkedIn:
“Effect of Prolonged Tourniquet Application
Prolonged tourniquet application (typically >1 minute) causes venous stasis, leading to hemoconcentration and localized metabolic changes. This is a well-documented pre-analytical error.
Proven Laboratory Effects
Falsely Increased
- Total protein, Albumin
- Calcium (protein-bound fraction)
- Hemoglobin, Hematocrit
- RBC, WBC, Platelet counts
- Potassium (especially with fist clenching)
- Lactate
- AST, CK
Falsely Decreased
- Glucose (local cellular uptake)
- pH (local acidosis)
Why this happens?
- Venous stasis causes plasma water to shift into interstitial space, while cells and large molecules remain intravascular → concentration effect.
Why it matters?
- Pseudohypercalcaemia
- Misinterpretation of dehydration
- Unnecessary repeat testing or inappropriate clinical decisions
Best-Practice Recommendation
- Apply tourniquet for ≤ 1 minute
- Release as soon as blood flow is established
- Avoid fist clenching
If delay occurs, release and reapply after 2 minutes.
Authoritative Sources
- CLSI GP41-Ed7 (2020)
Collection of Diagnostic Venous Blood Specimens. - WHO Guidelines on Drawing Blood (2010).
- McPherson & Pincus. Henry’s Clinical Diagnosis and Management by Laboratory Methods, 23rd ed.
- Lippi G et al. Preanalytical variability in laboratory testing. Clin Chem Lab Med.
Pre-analytical accuracy is patient safety.
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